The long-term objective of this research is to provide the information necessary to reduce death and disability from occupational injury. While much is known about work-related fatalities, little is known about the epidemiology of non-fatal injuries requiring treatment in an emergency department (ED) or admission to a hospital. This study seeks to develop a model for comprehensive statewide surveillance of occupational injuries. Available sources of data in Maryland will be linked to create an incident-specific database, which allows estimation of the incidence of occupational injury by population, by industry, and by occupation. In addition, validation studies of the reliability of reporting will be conducted. The study has the following six specific aims: (1) To develop a model system for statewide surveillance of occupational injuries, based on the linkage of available sources of data, including ED records, hospital discharge records, medical examiners records, death certificates, ambulance run sheets, police crash reports, trauma registry records, and emergency medical services communication logs. This will be a passive, retrospective surveillance based on data from 2001, 2002, and 2003. (2) To conduct a validation study of the reporting of work relatedness by available data sources based on sampled chart reviews of ED patients, inpatients, and deceased workers, in order to determine the nature and occupation of the patient and circumstances of the injury. In addition, false- positive and false- negative rates for work relatedness will be computed. (3) To collect in-depth information to identify injury circumstances through an active, prospective investigation of trauma patients, including in-depth interviews and screening by trauma nurses during 2003, 2004, and 2005. Data obtained from these sources will be corroborated with information from external sources. (4) To determine the strengths and weaknesses of available sources for identifying work-related injuries for 2003, the only year for which both passive and active surveillance data will be available. (5) To use knowledge resulting from this surveillance to make recommendations for a long-term, sustainable surveillance system for occupational injuries. (6) To identify priority areas for injury prevention within the state of Maryland, based on groups of workers at high risk of injury. [unreadable] [unreadable]